Stacey Gwen Johnson, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2017018527 Issued in MO

Practice address

402 N Keene St
Columbia, MO 65201-6986

Phone

(573) 499-6084

Fax

(573) 499-6088

NPI assigned

Jun 15, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Stacey Gwen Schneider Former name

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care for Women, LLCGroup PAC ID 5294826434, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stacey.johnson@hca2.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Care for Women, LLC

  • Gynecology Physician
  • Shawnee, KS
  • NPI 1467659813
  Medicare reassignment Care Compare group
• Midwest Division-Oprmc LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1578500484
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700316270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016986",
            "telephone_number": "573-499-6084",
            "fax_number": "573-499-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016986",
            "telephone_number": "573-499-6084",
            "fax_number": "573-499-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACEY",
        "middle_name": "GWEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2017018527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "2500041069",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SCHNEIDER",
            "middle_name": "GWEN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Quinn L Johnson, M.D.
• Raquel Judith Johnson, MD
• Rebecca Lynn Johnson, C.R.N.A.
• Sairah Johnson, MD
• Sandra Marie Johnson, M.D.
• Stephanie Johnson
• Susan Schuck Johnson, M.D.
• Taylor Judith Johnson, P.A.
• Tracy Darlene Johnson, PLPC
• William L Johnson, CRNA

• Obstetrics & Gynecology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.